Matthew David Williams, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS106101 Issued in CA

Practice address

133 S Myers St Apt C
Oceanside, CA 92054-2940

Phone

(208) 901-8619

NPI assigned

May 25, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1922456417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 S MYERS ST APT C",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542940",
            "telephone_number": "208-901-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 S MYERS ST APT C",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542940",
            "telephone_number": "208-901-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cordie Lee Williams, DC
• Destin R. Williams
• Erica Williams
• Jamie Nicole Williams
• Kaitlin Marissa Williams, DPT
• Susanna Williams, RD
• Tari Lynn Williams, C.A.S.
• Willow Tree Licensed Clinical Social Worker
• Ronald Joseph Willy, M.D.
• Andrew Roger Wilsnack, MD

• General Practice Dentistry in Oceanside, CA
• Providers in Oceanside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.